Organization
SHEPHERD'S PLACE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEBIN THOMAS PA (MANAGER)
(405) 414-9139
Entity
Organization
Contact information
Practice address
2316 NW 23RD ST, OKLAHOMA CITY, OK 73107-2406
(405) 605-3395
(405) 605-3673
Mailing address
2316 NW 23RD ST, OKLAHOMA CITY, OK 73107-2406
(405) 605-3395
(405) 605-3673
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17859
OK
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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